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PMI Phleb Final

PMI Phleb Final (Ch 7-10)

QuestionAnswer
What is aliquot? Aliquot is a portion of a specimen being tested.
What angle is the spreader slide? 45 degrees
What temp should be unused evacuated tubes be stored at? 4-25 degrees C
What is the best practice if the vein can be felt, but not seen even with a tourniquet on? Look for visual clues on the skin (freckles, scars, etc.)
What is another name for a butterfly? Winged infusion set
Why should the thumb not be used to feel for an artery? Because the thumb has a pulse
All of the following specimen need to be centrifuged except: CBC in a lavender (2 reasons why wouldn't be spun is not a clotter tube, potassium doesn't go in a heparin tube)
Needles are color coded by their? Gauge
What is most important consideration when drawing blood from an older child? Explaing the importance of holding still
Which anticoagulant prevent coagulation by inhibiting thrombin? Heparin
It is better to use gauze and not cotton balls for pressure because cotton balls are: Pull up platelets
Which of the following can be a complication resulting from deep skin punctures to an infant's heel? Osteochrondritis
What is some general criteria to consider for selecting a skin puncture site? Warm pink site
The type of care for someone who is terminally ill is known as: Hospice
Which of the following is acceptable angle for ABG? 45 degrees
Two part of a syringe is the graduate barrel and ? The plunger
Where is the tourniquet applied when drawing a hand vein? Proximal to the wrist bone
The most likely reason a phlebotomist would wrap a specimen in foil? To protect it from light
Which additive prevent glycolosis? Sodium Fluoride (NaF)
What is the preferred site for an arterial puncture? Radial artery
A glucose specimen in a sodium fluoride tube is stable at room temp for ? 24 hours
What is a most common, direct, efficient and preferred system for collecting blood systems? Evacuated tube system
The composition of skin punctured blood looks more like? Arterial and venous blood
To avoid an airborne infection while processing a specimen you should? Use the stopper remover or cover the stopper with guaze
If a patient adamantly refuses to have their blood drawn you should? Notify the nurse and fill out a failure to obtain specimen
What is the max amt of time a tourniquet can be left on before you have hemolysis? 1 minute
Why is skin puncture blood sometimes called capillary blood? It's obtained from the capillary beds
Why should serum tubes be transported with the stopper in the up direction? Aides in clot formation, reduces aggregation and prevents contents from coming in contact with the stopper
Approx how long does it normally take a serum specimen to clot completely at room temperature? 30-60 minutes
The color code that is most often associated with hematologic test is? Lavender
What should be done if a pt is still bleeding 10 minutes after checking the site? Notify the pt nurse/physician
When performing venipuncture hand washing is necessary: Before and after each pt
Why is it recommended to use several layer of gauze during needle removal? To prevent the gloves from being contaminated with blood
If you have an inpatient and they are not wearing an id band when you go to collect the specimen you hsould: Ask the patients nurse to put on an armband before drawing blood
Why should a phlebotomist visually inspect the needle tip before inserting it into the patients veing? To check for imperfections
Labeling a routine blood specimen should take place: At the bedside immediately after collection
What is the best angle for needle insertion? 15-30 degrees
What is the recommended skin puncture site on children 2 years of age or older? The fleshy portion of the middle finger
According to CLSI guidelines when is the best time to remove a tourniquet? As soon as blood flow is in the tube
Which of the following sites would be eliminated as a skin puncture site? An edemos or edematous extremity
It is important to mix anticoagulant tubes immediately after filling them to: Avoid micro clot formation
A skin puncture that parallels whorls of the fingerprint will: Allow the blood to roll down the finger
How many times must you mix non additive tubes 0 - zero
According to OSHA what does proper needle disposal involve? Disposing of the needle and the needle hold as one unite
Which of the following is not proper skin puncture procedure? Using provodone iodine
According to CLSI the maximum time from separating serum or plasma from cells is? 2 hours
It is suggested that additive tubes be gently inverted how many times as soon as they are drawn: 3-8 times
OOD for ETS Sterile yellow/BC bottles, Lt blue (FULL), Red, SST, PST Lt green, Green, Lavender, Grey
OOD for Syringe Sterile yellow/BC bottles, Lt blue (full), PST Lt green, Green, Lavender, Grey, Red, SST
Needle gauge size/color Pink - 18', Yellow - 20', Green - 21', Black - 22', Lt blue - 23' butterfly, Dk blue - 25' butterfly
When palpating what 3 things are we looking for? Size of vein, depth of vein, direction of vein
Name 3 things that cause hemolysis: Tourniquet time (1 min or less), Butterfly tube, Pt pumping/clenching fist, Wrong size needle, Shaking tubes, Excess heat, Long transport time, Pushing/pulling too fast on syringe, Not allowing antiseptic to dry completely
Tourniquet restrict arterial flow & allow venous? True or false False; tourniquet restrict venous flow & allow arterial flow
Abbreviation for the collections system typically used for routine venipuncture? ETS
Additive that prevents the breakdown of glucose by the cells Antiglycolytic agent
Additive used for immunohematology tests such as DNA and HLA typing ACD
Anticoagulant that inhibits the formation of thrombin Heparin
Anticoagulant that preserves cell shape and structure and inhibits platelet clumping EDTA
Breakdown or metabolism of glucose by blood cells Glycolysis
Coagulation-enhancing substance such as silica Clot activator
End of the needle that attaches to the blood collection device Hub
Number that is related to the diameter of the needle lumen Gauge
Point of a needle that is cut on a slant for ease of skin entry Bevel
Premeasured vacuum tube that is color-coded based on its additive Evacuated tube
Solutions used to kill microorganisms on surfaces and instruments Disinfectants
Substance added to blood collection tube Additive
Substance that prevents blood from clotting Anticoagulant
Substances used for skin cleaning that inhibit the growth of bacteria Antiseptics
Winged infusion blood collection set Butterfly needle
Additive used in blood culture collection SPS
Anticoagulant commonly used to preserve coagulation factors Sodium citrate (NaC)
Anticoagulant commonly used with an antiglycolytic agent Potassium oxalate (KOx)
Butterfly needle Winged infusion set
Clot activator Silica
Gel tube for separation of cells and serum SST
Heparinized gel tube for separation of cells and plasma PST
Internal space of a vessel or tube Lumen
Long cylindrical portion of a needle Shaft
Most common antiglycolytic agent Sodium fluoride (NaF)
Special puncture-resistant leak-proof disposable container Sharps container
Special sequence in which tubes are filled during a multiple-draw Order of draw
Synthetic substance used to separate cells from serum or plasma Thixotropic gel
Type of needle used to collect several tubes during a single venipunture Multisample needle
Type of needle used when collecting blood with a syringe Hypodermic needle
Anticoagulants (7) ACD, CPD, EDTA, Heparin, Potassium oxolate (KOx), Sodium citrate (NaC), SPS
Antiglycolytic agent Sodium fluoride (NaF)
Clot activator Silica
Serum/plasma separator Thixotropic gel
Binds calcium (3) Citrate, EDTA, Potassium oxalate
Enhances coagulation Silica
Inhibits thrombin Heparin
Physical barrier Thixotropic gel
Preserves glucose Sodium fluoride (NaF)
An antiglycolytic agent: Prevents the breakdown of glucose
Sharps containers do not have to be: Recycable
Which substance would be the best thing to use to disinfect a blood spill on a lab counter-top prior to cleanup? 1:10 dilution of bleach
This needle is standard needle for routine venipuncture 21 gauge
What would be the best choice of equipment for drawing a small hand vein? 23 gauge butterfly and ETS holder
Which of the following equipment is required in collecting blood by syringe? Transfer device
Which anticoagulant prevents coagulation by inhibiting thrombin formations? Heparin
What tube would typically be used to collect plasma for a stat chemistry specimen? Green-top (lithium)
EDTA is a(n) Anticoagulant
A light blue topped tube is most associated with what department? Coagulation
Which tube is filled 2nd from a syringe according to CLSI? Lt blue (FULL)
PST contains? Heparin and gel
For which tube is the blood to additive ratio most important? Lt blue (FULL)
Which additive provides a physical barrier to prevent glycolysis? Sodium fluoride (NaF)
Which tube contains an anticoagulant that works by binding calcium? Lt blue (FULL)
What is the purpose of a royal blue top tube? Minimize trace-metal contamination
The following supplies were gathered for a routine venipuncture. Which is incorrect? A: ETS tubes B: Iodine swab C: Safety needle D: Tourniquet A: ETS tubes
Which tube can be used to collect a serum specimen? Red top
A tourniquet is used in venipuncture to: Find and enter veins more easily
What substance do you use to clean the site of venipuncture on a pt with no known allergy to antiseptics? 70% isopropyl alcohol
Which needle has the largest gauge? 18 gauge
What causes evacuated tubes to fill with blood automatically? Premeasured tube vacuum
Lavender top tubes are most commonly used to collect: Hematology tests
A butterfly is typically used for: Difficult and hand veins
A eutectic mixture of local anesthetics EMLA
As soon as possible ASAP
Behavior of a healthcare provider toward a pt or as perceived by a pt Bedside manner
Do not resuscitate/do not attempt resuscitation DNR/DNAR
Identification bracelet (abbrev) ID band/bracelet
No food or drink except water for 8-12 hours Fasting
Record in the order received Accession
Secure firmly, as in holding a vein in place by pulling the skin taut with the thumb Anchor
Series of black stripes and white paces that correspond to letters and numbers Barcode
Two other names for an identification band/bracelet Arm/wrist band
Type of care for terminally ill patients Hospice
Backflow of blood from the tube into the vein during a draw Reflux
Before an operation or surgery/after an operation or surgery Preop/postop
Clinic-issued patient identification document ID card
Covering or cap of a needle Needle sheath
Form on which test orders are entered and sent to the lab Requisition
Immediately (from Latin statim) STAT
Intense fear of needles Needle phobia
Medical record number used for patient ID MR number
Nothing by mouth (Latin nil per os) NPO
Process of verifying a patient's identity Patient ID
State of being freely open Patency
To examine by feel or touch Palpate
Actively involve the pt in this procedure You need to verify patient ID
Advise the pt to ask the nurse or physician Pt asks for the purpose of the test
Ask someone to help steady the pt's arm Unconscious pt
Ask the pt to remove it Outpatient is chewing gum
Check the ankle after asking the pt's permission ID band not on the pt's arm
Consult with the nurse or physician before proceeding Specimen must be fasting but pt has eaten
Do not draw blood without pt consent Conflicting permission statement
Have the most skilled phlebotomist draw the information Needle-phobic pt
Make certain that the pt knows this information You are a phlebotomy student
Remind the pt that the doctor needs the test results Pt initially objects to testing
Detect and montor diabetes. Abnormal levels can cause confusion, seizures, or coma or lead to peripheral neuropathy. Glucose
Detect inflammation; identify collagen vascular diseases ESR
Determine hemoglobin levels, detect infection, and identify blood disorders CBC
Determine sodium and potassium levels critical to proper nervous system function Electrolytes
Diagnose kidney function disorders that may be responsible for problems such as confusion, coma, seizures, and tremors BUN/creatine
Diagnose lupus and rheumatoid arthritis, which can affect nervous system function ANA/RNA/RF
Identify abnormal levels associated with seizures and muscle problems Calcium/magnesium
Identify protein or immune globulin disorders that can lead to nerve damage SPEP, IPEP
Monitor blood-thinning medications; important in heart conditions, coagulation problems, and stroke management PT/PTT
Diagnose or rule out syphilis, which can cause nerve damage and dementia VDRL/FTA
A vein that has patency: has a bounce and resilience to it
What type of lab requisition has been shown to decrease laboratory errors Bar coded
Time is 0750 hours. You received the following test requrests on different pts. Which test specimen should you collect first? A: CBC ordered ASAP B: Cortisol ordered for 0800 C: Fasting glucose D: Postop hemoglobin B: Cortisol ordered for 0800
A student asks the pt for permission to draw blood. What answer implies that the student does not really have permission? Yes, but I would rather not.
You have a request to collect a stat specimen. A doctor is with the pt when you arrive. What should you do? Excuse yourself and politely ask the doctor for permission to do the draw.
You are in the process of identifying an inpatient. The pt's verbal confirmation of name and DOB matches the requisition, but the MR number is different. What should you do? Do not collect the specimen until the problem has been addressed and resolved.
You are a phlebotomy student on a rotation at an outpatient site. A pt who seems extremely apprehensive about having her blood drawn tells you that she is afraid of needles. What should you do? Ask an experience phlebotomist to perform the draw for you
There are 2 pts in a room. One of them has a latex allergy. You have a request to collect a blood specimen on the other one. How should you proceed? Do not take anything that contains latex into the room.
The best way to judge patency of a vein is to: Press and release it several times to determine resilience
What is a proper venipuncture technique? Fill additive tubes until the vacuum is exhausted
What is the most critical error a phlebotomist can make? Misidentifying a pt specimen
Which needle can be removed from the blood collection unit before disposal? Syringe needle
When should additive tubes be mixed? As soon as they are removed from the holder
You have 2 unsuccessful attempts while trying to collect an ASAP specimen on an impatient. The specimen cannot be collected by skin puncture. What should you do next? Ask another phlebotomist to collect it.
The proper way to transfer blood from a syringe into an ETS tube is to: Safely remove the needle and attach a transfer device to fill the tube
How can you tell that you are in a vein when drawing blood with a butterfly? Blood usually appears in tubing
You are performing a venipuncture on a difficult vein using a butterfly. You have an SST and a lt blue top tube to collect. How do you proceed? Draw a clear tube, fill and mix the lt blue, then fill and mix the SST.
Interventions to ease pain in collecting blood specimens from infants include: EMLA, oral sucrose, pacifiers
Skin changes in elderly pts can make it hard to: Anchor veins
Which type of disease is most likely to cause tremors? Parkinson's
T or F: Bilirubin tests are to be protected by the light, using tin foil or amber tube True
T or F: PKU tests should dry for a minimum of 3 hours, vertically False
T or F: EDTA does not bind calcium False
T or F: The gauge of a needle refers to the length of the needle False
T or F: PTTs are analyzed in the chemistry department False
T or F: A phlebotomist may "stick" a pt up to 3x maximum False
T or F: When conducting a fingerstick, the lancet blade should be parallel to the pt's fingerprint False
T or F: Aspirin is not considered a blood thinner because it is not a prescribed medication False
T or F: ESR is not the same as a sedimentation rate False
T or F: Allowing the antiseptic to dry completely can cause a specimen to be hemolyzed False
T or F: Small preprinted labels are considered requisitions and/or PHI True
T or F: A sheath of a needle is sometimes referred to as the "cap" or "cover" True
Required information on a requisition (9) Physician's name Pt's first & last names & middle initial Pt's MR #(inpatient) PT's DOB Room # & bed(inpatient) Type of test performed Date test performed Billing info & ICD-9 codes(outpatient) Test status(timed, fasting) Special precautio
A member of the clergy is with the pt when you arrive to collect a routine specimen. What should you do? Come back after the clergy person is gone
You are asked to collect a blood specimen from an inpatient. The pt is not wearing an ID band. What should you do? Ask the pt's nurse to put an ID band on the pt before you draw the specimen
If a pt adamantly refuses to have blood drawn you should: Notify the pt nurse or physician and notate
An inpatient is eating breakfast when you arrive to collect a fasting glucose. What is the best thing to do? Consult with the pt's nurse to see if the specimen should be collected.
After cleaning the venipuncture site with alcohol, the phlebotomist should: Allow the alcohol to dry completely
The tourniquet should be released As soon as blood flow is established, before needle removal from the arm, and within 1 minute of its application
T or F: A syringe is sometimes used for veins that collapse easily True
After inserting a butterfly needle, the phlebotomist must "seat" it, meaning Slightly thread it within the lumen of the vein
Blood collection tubes are labeled Immediately after specimen collected
What is the best approach to use on an 8-yr-old child who needs to have blood drawn? Explain the draw in simple terms and ask for the child's cooperation
Which type of pt is most likely to have an arteriovenous fistula or graft? Dialysis
What is proper procedure when dealing with an elderly pt? Make certain to hold adequate pressure after the draw until the bleeding stops
Peak levels of this analyte typically occur around 0800 hours? Cortisol
What tests are most affected if the pt is not fasting? Glucose & triglycerides
Veins that feel hard and cord-like when palpated may be Thrombosed
Tiny red spots that appear on a pt's arm when the tourniquet is applied is a sign that The site may bleed excessively
When the arm of the pt is swollen with excess fluids, the condition is called: Edema
A pt has several short lengths of IV-type tubing protruding from his chest. This is most likely a/an: CVC
What would most likely to allow reflux to occur during venipuncture? Filling the tube stopper end-first
What can result in hemoconcentration? Leaving the tourniquet on over 1 minute
You are in the process of collecting a specimen by venipuncture. You hear a hissing sound, there is a spurt of blood into the tube, and blood flow stops. What has most likely happened? Tube vacuum escaped
What is the minimum amount of blood required for BC bottles? 10ml, but filling is preferred
What is required on the BC bottle(s) label? Pt name, Pt id#, date of collection, time of collection, phleb's initials, number of number collections, area/site of draw
What color is a peds BC bottle? Pink
What 4 things can you NOT do during BC bottle venipuncture? Retouch site to repalpate, redraw from same area, draw above IV site, cover bar code on bottles
How long is a friction scrub? 15-30 seconds DO NOT remove from skin during scrub; if you do, start all over
What allergies do you need to ask about during BC bottle collection? Latex and shellfish/iodine
What type of needle should be used for BC bottle(s) collection? Always butterfly
What antispectic(s) is(are) used for a pt without a shellfish/iodine allergy during BC bottles collection? Alcohol and iodine
What antispectic(s) is(are) used for a pt with a shellfish/iodine allergy during BC bottles collection? Chloroprep
Created by: rainie529